Third miscarriage - what kind of testing is now available?

[NancyPreg]

Morning ladies, I know this part of Mumsnet contains a wealth of experience and support for women who have had repeated MC and I'm hoping to tap into some of that if possible.

Today, I woke up with my third mc (in 8/9mths). My first two were both missed, discovered at 12wks so today's spontaneous mc at 5wks is actually a 'better' outcome for me IYSWIM.

I know that now I've reached the magic miscarriage number of 3, I will be eligible for some tests but I've really got no idea what kind of tests are available, when I should have them, what I should do to get them, where I should go, etc.

If anybody can help me, then it would be hugely appreciated.

Hi Nancy, I saw your post this morning and had hoped that someone with the right knowledge would have been along by now to answer you. I am very sorry for your losses.

I don't know the answer to your questions but just wanted to bump for you and leave my sympathy at this horrible time. I've had a "shock" 12-week miscarriage and an earlier miscarriage to so I know what you mean when you say it is better outcome.

hI hope you start to heal soon and get some answers. Cx

Your Gp should refer you to a recurrent miscarriage clinic for testing - they will test for clotting disorders, do a scan to check your uterus etc, plus give you a plan for your next pg (early scans etc)

My third mc was an ERPC, and I insisted on the hospital starting the test process

Hi - I just had my first recurrent MC appointment yesterday.

I asked GP to refer me, then I had to select a hospital through the choose and book system - went for a local one as all the ones with good reputations had amazingly long waiting lists.

They took loads of blood yesterday to do tons of hormone stuff, plus testing for clotting and immune issues that could be resolved by taking aspirin / heparin in early pg.

I have to go back for them to take more blood for tests on myself and DP to ensure we are compatible. If we are not, then it gets tricky and we might apparently be looking at IVF or egg donation

I get called back for another appt in 8 weeks. In the meantime, I've been told that even if I just suspect I am PG, I can call the EPU there and get early blood tests and they will start treatment immediately based on what test results have come in. I think the best thing about now being under the care of that clinic is all the early scans, testing and reassurance I will get next time

Hope that helps - lots of good explanations here if you follow the links to causes and treatment on the right hand side.

Sorry for your losses but you should now be able to get some investigation. See your GP to get referred to the recurrent miscarriage clinic. You will probably have to have some scans and blood tests initially to see if they can find a cause.

I hope they can find some answers for you.

what everyone else said
and possibly check you / dp for any chromosome rearrangements (like balanced recipricol translocation) Blood tests.

can take a bit of a while all in all.

sorry for yr mcs - hope it works out for you soon

cyan - many thanks for your kind thoughts and words, it means a lot. Sorry for your two losses too and best wishes for your next pg.

cmot and lozza - thank you for your replies and advice, I have made an appt to see a doctor next week. cmot - how far along the testing process are you? Did you get any answers for your three sad losses?

jools - I don't live anywhere near the big three recurrent miscarriage hospitals - but do all hospitals offer similar types of services? I'm guessing you've also had three losses, so my sympathies go out to you. I hope all the tests that you are undergoing will provide some answers and a way forward.

Apart from the hormone, internal and clotting tests, do they test for chromosomal problems (karyotyping) too?

Many thanks for your replies. It's so sad that so many of us have accumulated so much unwanted knowledge about mc.

they should do NancyPreg

flappy - thanks for your reply and best wishes. I guess the end-to-end process will take a good few months to sort out but at least I'll feel as though I'm doing something.

jools - I'll check out the link, thanks.

Nancy - yes, they do some chromosomal testing - not sure exactly what it is, as I didn't see the consultant - only an assistant who did all the paperwork but wasn't too hot on explaining stuff !

I live in Herts and was offered a choice of the Royal Free, Luton and Dunstable or the QE2 in Welwyn Garden City - the Royal Free had no appointments, so I went for the QE2 as it is local.

Judging by that, I would guess that a large variety of big hospitals have such clinics - be warned though, I ended up in the same waiting room as the antenatal appts / day assessment unit / EPU, which was a little disconcerting at first.

Oh, and I only had to wait just over 3 weeks for an appointment

Thanks Nancy. I had DS (now 2) in between my two mcs so won't be getting any tests for a bit yet.

It's good in a way that you will have something positive to focus on in the next few months, I wish you all the best.

jools - that's good service! I hope we get seen within a month! And yes, I can vividly remember turning up for my 12wk scan with my first MMC...the receptionist wasn't particularly discreet when I told her that she would have to cancel the 20wk scan, think she let the whole clinic room know, 'so you want me to cancel the 20wk scan?' . It was so obvious what we'd just experienced and then we had to walk past all the pg ladies who were waiting their turn. Grrr.

cyan - thanks for your best wishes and same to you too. Lovely that you had you ds!

Is it always 3 MC's you have to have? I've just had my 2nd late MC and the surgeon after my ERPC suggested I got tested. My GP says as I already have one dd this isn't necessary and hospital didn't put the suggestion of testing in the discharge papers only that I should be treated as high risk next time?

Hello, I have just looked at your message and thought I would reply. I have had 4 miscarriages. My 1st on 13th April 2004, then 5th May 2005, then 27th January 2006. At this point I was very upset but refused to give up, I said to my husband that I would not give up until I had a baby. My 3rd miscarriage resulted in a D & C, I have had numberous blood tests so did my husband and nothing substancial could be found, the hospital thought the blood samples that came back normal were border line and the samples they thought would be the problem came back normal. Then just 4 weeks later I caught again, my 4th pregnancy and it went smoothly and I have a beautiful baby girl 2years old, born by c-section. Then I caught again in 2008 and unfortunately miscarried again. I resuse to give up and hopefully will still have a 2nd baby, then maybe i,ll call it a day. But don,t give up, you will have a little miracle.

Hi, been reading all your posts,I am so sorry to all of you who have suffered msc.
I started miscarrying on Sunday (7th) So its all still happening to me at the moment.
This is my 2nd miscarriage, my first one was in Oct 2008, i was 5 weeks, it then took me 6 months to conceive and I have miscarried again at 8.2 weeks.
This time has been awful because I was much furter on.
I have 2 children, 1 DS (12yrs) from a previous relationship and another DS (2) with my DH.
Its all a bit confusing because I went for an early scan at 7 wks only to be told that everything looked as it should but i only looked about 5 weeks so therefore it was too early to detect a heartbeat.
At first i found this really worrying, but as you dont know exactly when you ovulate it could be possible, so was due to go back yesterday for another scan.
Obviously started MSC Sunday went for the scan and there was nothing left, ( although without going into too much detail there certainly seems to be IYKWIM).
I also felt really confident tht things were fine as i had all morning sickness, metallic taste in my mouth, boobs sore etc, but saturday i felt pregnant and Sunday it started.
i wanted to ask if anyone has had an internal to see if your womb is closed when you start to bleed??
I went to the emergency doctor who said that he needed to examine me to see if it was closed or open.
I just kind of thought at the time because i was so upset that he knew what he was doing, but is that safe to do? Would it not open it up more?
Also After my first miscarriage i never had any support whatsoever as i was so early, I wasnt seen and wasnt even given a leaflet, so this time I was and i read the leaflet and although no one really knows why this happens it did have some possible causes. One of them being a weak cervix.
i had to have a cone biopsy to remove pre cancerous cells before DS2, and although I carried DS2 with no problems I am wondering whether this has now weakened my cervix so that I am no longer able to carry a baby full term? has anyone else had this?
As for them saying that you have to have 3 miscarriages before they will investigate( absolutely unacceptable, bet they havent been through it themselves), I am going to insist my doctor atleast refers me to be checked out regarding my cervix but if she doesnt i dont know what i'll do, its just an awful thing to have to go through .
Anyway if anyone feels like answering please do, in a bit of a crap place right now. Dont get me wrong I am very grateful that i have 2 children I really am. I just wanted to give DS2 a playmate as my DS1 didnt have that growing up and was very lonely, it took me a long time to meet DH! I'm so sorry its so long I;ve been ranting on....
Love to you all xx

Hi guys,

I had my 4th Mc 4 weeks ago and after my third i was referred for investigations now i must say that i had my appointment in feb and i only got my blood tests back this week and have a further appointment for the 15th of july. my local hospital has been realy shit. They have however found out the problem, i have Factor V Leiden and Possibly Protein S Deficiency (both blood clotting disorders) so i will have to probably take aspirin for the rest of my life and heparin when i am pregnant.
Me and DH have been trying for 5 yrs so we are getting alittle desperate now although we do have a 7yr old DD.

Jools its sounds like your hos is going to be great, after i had my third Mc i thought i would be under close care with the EPU but when i fell for the 4th time i had a scan at 7weeks which was all fine and basically told to go away, i never heard from them again until i had to go in for an ERPC for the MC. ( had a private scan at 10 and a half weeks that showed no HB). i still havent been told what to do if i fall again. i realy am considering making an complaint.

Anyway not over the Mc as yet, i find it very hard to keep it together but have to to, so everyone thinks i am ok but inside i'm realy not.

There is a song that realy fits what we have all been going through at least i think.

"The lights go out all around me, one last candle to keep out the night. And then the darkness surrounds me. I know i'm alive but i feel like i've died.
And all thats left is to accept that its over, my dreams ran like sand through the fists that i made. I try to keep warm but i just grow colder, i feel like i'm slipping away.

After all this has passed i still will remain.
After i have cried my last there will beauty from pain.
Though it won't be today someday i'll hope again and there'll be beauty from pain. You will bring beauty from my pain.

My whole world is the pain inside me the best i can do is just get through the day. and life before is only a memory. I wonder why God lets me walk through this place.
And though i can't understand why this happened i know that i will when i look back someday and see how you have brought beauty from ashes and made me as gold, purified through these flames.

After all this has passed i still will remain.
After ive cried my last there'll be beauty from pain.
Though it wont be today someday i'll hope again and there will be beauty pain.

Here I am at the end of me trying to hold to what i cant see. I forgot how to hope this nights been so long. I cling to the promise there will be a dawn.

Chorus again.

Its sung by superchicks if you go onto utube and type Beauty from pain.

some off you may think i am mad but sometimes songs feel like they have been written for me and what i have gone through.

Blood Tests
Day 2-6 FSH and LH to exclude Polycystic Ovarian Syndrome (PCOS)
HbA1C to exclude diabetes
Thyroid function tests
Chromosomes (patient and partner)
DRVVT to exclude Lupus Anticoagulant (repeated twice at least 6 weeks apart)
Anticardiolipin Antibodies (repeated twice at least 6 weeks apart)
Factor V Leiden, Prothrombin Mutation Analysis, Protein S, Protein C, Activated Protein C Resistance (APCR), Anti-Thrombin III.

These are the sorts of tests that I have been told that you may possibly need. I have had tow Missed miscarriages, and am thinking of maybe getting tested privately, as the nhs seem to be so useless